Quebec is expected to hold public hearings this fall on its controversial right-to-die legislation, tabled Wednesday in the national assembly. But in many circles, the debate has already begun.

Quebec’s landmark bill would open the door to allowing terminally ill patients to have a doctor administer medication to cause death. If it passes, it would be the first legislation of its kind in Canada.

Assisted suicide and euthanasia are both illegal under Canada's Criminal Code, but the Quebec government says it has jurisdiction on the matter, because delivery of health-care services is a provincial responsibility.

Alex Schadenberg, the executive director of the Euthanasia Prevention Coalition, opposes the bill, saying what’s really needed in Canada is improvements to the country’s palliative-care system.

“People don’t want to be suffering or in significant pain and that’s what we should be looking at. That’s what palliative care is supposed to be and we need better palliative care,” he told CTV’s Canada AM, speaking from London, Ont.

Quebec Social Services Minister Veronique Hivon said Wednesday she is confident Bill 52 will not trigger Criminal Code sanctions because the bill deals with Quebec’s responsibility in the area of health.

“There is nothing in the Criminal Code that deals specifically with an act to put an end to suffering in a medical context,” she said.

Schadenberg doesn’t agree this is a health issue. “Euthanasia is taking the life of a person; it’s not about withdrawing treatment or pulling a plug, it’s about actually injecting someone with a lethal dose. How could that be health care?” he said.

Dr. Kerry Bowman, a bioethicist with the University of Toronto who specializes in end-of-life decision-making, agrees that what’s needed first is improvements to the way patients die in Canada.

“In Canada, we’re not providing fabulous end-of-life care. We need to do so much better … So I worry that if we move forward in this domain, we could have Canadians asking for assisted death because we’re not providing good care for them,” he said.

But he added that it’s clear from surveys that many Canadians want something to change in this country’s stance on euthanasia.

“I think we do need to move forward with this. Because there is a small subset of people who really do have horrendous pain and suffering and who really want to no longer be living,” he said.

Bowman added he also wants to be sure the bill would contain protections for doctors who are not comfortable with helping patients to die.

“I would argue that doctors should have the right to say they don’t want anything to do with this,” he said. “I can’t imagine a situation where all doctors would be expect to do this; many would not accept it.”

The proposed legislation would apply only to patients over the age of 18 who are suffering from a terminal disease. They must also be suffering from "constant and unbearable physical or psychological pain which cannot be relieved in a manner the person deems tolerable."

The legislation would require the patient to state their intention to die in writing, have a doctor agree, and then have a second doctor confirm medically aided death is the only way to end the patient's suffering.

Federal Attorney General Rob Nicholson said Ottawa would review the implications of the proposed legislation, but noted that “a large majority” of parliamentarians voted not to change Canada’s assisted suicide laws in 2010.

“The laws that prohibit euthanasia and assisted suicide exist to protect all Canadians, including those who are potentially the most vulnerable, such as people who are sick or elderly, and people with disabilities,” he said in a statement.

“This is a sensitive issue for many Canadians, with deeply held beliefs on both sides of the debate.”